EVMS Autism Spectrum Disorders Program - FAQ

How do I make an appointment with the ASD (Autism Spectrum Disorders) program?

Please contact EVMS Psychiatry and Behavioral Sciences at (757) 446-5888 and ask for the ASD program. Your request will be reviewed and, in most cases, an appointment will be given to you. You will be sent an information packet through the mail.

What is ASD?

The diagnosis of Autism has changed according to the Diagnostic and Statistical Manual of the American Psychiatric Association. There are no longer separate diagnoses of Autism, Asperger's Disorder, and Pervasive Developmental Disorder NOS. All of these diagnoses fall under the Autism Spectrum Disorders diagnosis which is modified by the level of severity with one being the least and three being the most severe. The two main criteria are impairments in social communication and the presence of restricted interests and/or repetitive behaviors.

How common is it?

The latest figures state that 1 in 88 children age 8 have an Autism Spectrum Disorder based on the Centers for Disease Control statistics. No one knows exactly why the number of individuals with ASD is increasing. ASD knows no racial, ethnic, or social boundaries; family income levels; lifestyle choices; or educational levels. If one member of a family has ASD, there is a greater chance of other family members having ASD. It is four times more likely to occur in boys than in girls, but we don't know why.

How do I know if my child has ASD?

The characteristic behaviors of ASD may or may not be apparent during early childhood (24 months to 6 years). Sometimes children will develop normally and then lose their milestones especially in language and social interaction. Before two years of age, subtle changes (e.g. avoiding eye contact) may be present but hard to discern. As part of a well-baby check up, your child's doctor should ask specific questions about your baby's progress. The National Institute of Child Health and Human Development (NICHD) lists five behaviors that signal further evaluation is warranted:

• Does not babble or coo by 12 months• Does not gesture (point, wave, grasp) by 12 months• Does not say single words by 16 months• Does not say two-word phrases on his or her own by 24 months• Has any loss of any language or social skill at any age

Having any of these five "red flags," does not mean your child has an ASD, but that a further evaluation may be needed.

In addition to recognizing ASD in early childhood, some children with less severe forms of ASD may not be diagnosed until the demainds of their social environment exceeds their limited abilities. These children are socially awkward and frequently withdrawn. They frequently have no friends as they do not know how to manage a friendship. They have trouble undertanding their own emotions and those of others. They may have restricted interests in video games, art, collecting various items, etc.

How will the doctor know that I/my child has ASD?

Unless you have a specific genetic disorder that causes ASD (e.g., Fragile X syndrome), there are no additional medical tests to confirm a diagnosis of ASD. Your doctor will be sure you have received a full evaluation to rule out other medical problems that mimic ASD symptoms (e.g., ADHD). An accurate diagnosis must be based on observation of the individual's communication, behavior and developmental levels. There are new, more specific psychological tests that can help make the diagnosis (e.g Autism Diagnostic Observation Schedule or the Autism Diagnostic Interview-Revised). Other illnesses like anxiety, mood swings, and intellectual disability may be present along with an ASD so additional testing and careful diagnosis may be needed. A brief observation in one setting is usually not sufficient and a team approach to diagnosis is common. At first glance, some persons with autism may appear to have an intellectual disability, a behavior disorder, problems with hearing, or even odd or eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program.

What can be done to treat an ASD?

There are few treatments for the core symptoms of ASD but many therapies can help substantially, such as:

• speech therapy to improve verbalization and communication

• occupational and physical therapy to improve fine and gross motor functioning• social skills groups to improve social interaction• behavior modification to help change dysfunctional behaviors• individual therapy to ease adjustment to the diagnosis• family therapy to help the family adjust and relate to teh person with ASD• medication to help manage anxiety, depression, frustration, and behaviors• good medical care to help with GI problems, sleep, etc.

Does someone have ASD for a lifetime?

Yes. However, the therapies listed above can help the individual with ASD improve their level of coping and functioning significantly.

Can someone with ASD ever have a job?

Yes. Many individuals with ASD are high-functioning and have a variety of jobs. For example, Temple Grandin, a well known woman with ASD, took her specific interest in animal behavior and improved the cattle industry. Given sufficient support, an individual with ASD can usually have various levels of employment.

Aren't medications dangerous?

Some of the medications used to treat the symptoms of ASD can have serious side effects. The benefits of using the medication and helping an individual with ASD live more happily may be worth the risk of using the medication. Your doctor can help you with that information and in making those choices.